Vol 22, No 2 (2016)

The article presents result of analysis of indicator of polymorbidity in sampling of 9871 patients of therapeutic clinic of the research institute of experimental and clinical medicine (Novosibirsk)during 2003-2011. The study was carried out using archive method with statistical analysis of all nosologic forms, groups and classes of ICD-10 irrespective of particular diagnosis being main or concomitant. The gender differences of indicator trans-systemic polymorbidity during 2003-2011consisted in that in males its increasing was more dynamic than in females. The trans-systemic polymorbidity is correlated with social economic indicators considering as stressors having significant importance for its occurrence and development. These regularities are more specific for males due to direct correlation between trans-systemic polymorbidity and level of payroll salary in contrast with females. Hence, necessity to take into account impact of social economic factors on development of polymorbid pathology for improving system of secondary and tertiary prevention, diagnostic, treatment and rehabilitation of concomitant nosologies in patients. The development of new medical economic standards of treatment of patients with polymorbid pathology to implement principles of personified medicine is required.

The article considers various clinical models of such pyoinflammatory diseases as deep pyoderma, exacerbation of chronic salpingo-oophoritis, chronic pyelonephritis, implemented to establish determining effect of pathogenesis and possibly basic treatment of pathologic processes on character, intensity of immunopathology, effectiveness and mechanisms of action of pharmacological immune correction.

The study was carried out to establish relationship between occurrence of «atypical» infections in patients with acute obstructive and recurrent obstructive bronchitis and development of bronchial asthma based on concept of risks. Material and methods. As regards material for study the data of medical histories of patients hospitalized with acute obstructive and recurrent obstructive bronchitis and who were applied analysis for antibodies to «atypical» microflora (796 patients). The time-period of study made up four years from 2008 to 2011. During analyzed period immune enzyme analysis was implemented concerning antibodies to «atypical» microflora (Chlamydia pneumonia, Micoplasma pneumonia, Micoplasma hominis). The concept of risks’ identification was based on identification of ultimate risk in exposed and non-exposed groups, attributive risk, relative risk, population attributive risk. The standard errors and confidence interval for every type of risk were applied. Results. The methodical aspects of detection of relationship between occurrences of «atypical» infections in patients with acute and recurrent obstructive bronchitis and development of bronchial asthma were considered on the basis of concept of risks. The applied analysis demonstrated direct dependence of increasing of number of cases of development of bronchial asthma against the background of «atypical» infections. In the risk group the rate of occurrence makes up to 14,84%, in the control group - 1,67%, risk factor increases probability of development of bronchial asthma on 13,17%. The occurrence of “atypical” infection leads to increasing of cases of development of bronchial asthma up to 8.9 times. The index of potential harm made up to 7.59 i.e. if there are «atypical» infections in patients with acute and recurrent obstructive bronchitis every eighth exposed individual bronchial asthma is developed.

The article summarizes the WHO materials, regulations of normative documents, scientific publications’ data from certain foreign countries and Russia concerning interchangeability of vaccines against viral hepatitis B for immunization of adult population. The implemented analysis of data of foreign and Russian studies demonstrated compatibility of vaccine against viral hepatitis B from different manufacturers by parameters of immunological, preventive and epidemiological effectiveness that permits assuming possibility of their equivalent substitute.

According the data of study «EPOCHA-O-CHSN», most of Russian patients with chronic cardiac insufficiency have noncompromised ejection fraction of left ventricle. Therefore, the problem of diagnostic of diastolic chronic cardiac insufficiency seems to be extremely actual. The presented review describes pathogenesis of diastolic dysfunction of myocardium of left ventricle including both hemodynamic and molecular components of this process. It is also related about modern approaches to diagnostic of diastolic cardiac insufficiency. The special emphasis is made on results of Doppler analysis of tissue and stress echocardiography.

The article considers particular aspects of epidemiology and pathogenesis of neurological disorders detected in patients with acute pancreatitis. The pancreatic encephalopathy characterizing by various focal neurological symptomatic and sometimes rapid development of dementia is considered as a rare complication of acute pancreatitis developing in 9-35% of patients with diseases of pancreas. Factually, every patient with acute pancreatitis has a risk of development of pancreatic encephalopathy which significantly increases graveness of course and lethality of disease. Therefore, the emphasis is made on development of diagnostic algorithm under pancreatic encephalopathy permitting discovering this complication of acute pancreatitis at as much as possible early even possibly at pre-clinical stage. The comprehensive investigation of pathogenesis of pancreatic encephalopathy with the purpose of elaboration of pathogenetically conditioned therapeutic algorithm considering all parts of pathogenesis.